STRABISMUS

DR JAY DAXINI
OPHTHALMOLOGY RESIDENT
RUBY EYE HOSPITAL
 The number of extraocular muscles: 7.
I. LPS/Levator Palpebri Superioris : Elevation of the upper eyelid.
2. MR/medial Rectus: Inward movement/adduction.
3. LR/Lateral Rectus outward movement/abduction.
Mnemonic: S04 LR6 (lateral rectus is supplied by ab- ducents nerve).
 The rules for clinical actions of extraocular muscles

All the primary actions of the muscles predominate in the abducted eye.

All the secondary actions of the muscles predominate in the adducted

eye.

Clinical actions/clinical testing:

SR: Elevation in abduction.
IR: Depression in abduction.
SO: Depression in adduction (ask the patient to look at the tip of the
nose).
10: Elevation in adduction.
. Hering's law of equal innervation to a pair of yoke muscles:
It is applied in:
Secondary deviation.
. Inhibitional palsy.
Not followed in DVD (Dissociated vertical Deviation)

. Sherrington's law of reciprocal inhibition:

For two yoke muscles to contract, each of the antagonist muscles of the yoke
muscles should relax. For example, to look to the right side, RLR and LMR (yoke
muscles) should contract (according to 60 dardegisbadenadesea and LLR
(antagonist muscles) should relax (according to Sherrington's law).
For each binocular vision, there are at least 4 muscles which act together, wherein
two of them contract and two of them relax
Contraction of the muscles is affected in nerve palsies. Relaxation of the muscles is
affected in spasmodic
 Bruckner's test
used for screening of squint in infants.
method → By direct ophthalmoscope to illicit fundal red reflex → Compare
brightness and intensity in both eyes.

Equal brightness & colour Normal eyes.

Crescent of different colour intensities → Refractory error.

Difference in brightness Darker eye: Normal brighter eye → Squint.

Cover uncover test
Cover test:
used to confirm tropia. (CT: Cover test Tropia).

Uncover test:
used to diagnose phoria.
(uncover test Phoria).

Deviation.
Opposite.
of.
movement seen.
MADDOX ROD TEST